AB1814-HPR RHEUMATOLOGY NURSING OUTPATIENT CLINIC IN PORTUGAL
Authors: L. Barbosa, J. Santos, A. Cordeiro, M. J. Santos, E. Pereira
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic inflammatory rheumatic diseases are characterized by being chronic diseases. These diseases affect the person, in their various dimensions and are often associated with pain, loss of mobility and function, fatigue, anxiety and depression (Matcham, Norton, Scott, Steer &amp; Hotopf, 2016; Primdhal &amp; Esbensen, 2020; Ryan, 2020). The complex needs of these patients require and benefit of an advanced nursing practice and a guided and specialized attention that can be provided in a nursing clinic. The awareness of rheumatic patient needs and lack of this type of care led, to our knowledge, to the development of the first rheumatology nurse clinic in Portugal. <h3>Objectives</h3> Characterize a guided nursing clinic with the aim to support patients with systemic inflammatory rheumatic diseases, mainly initiating subcutaneous (sc) classic and biological DMARDs. <h3>Methods</h3> Summarized description of first guided rheumatology nurse clinic in Portugal. <h3>Results</h3> This nurse clinic was created and developed during the pandemic period of SARS-CoV 2 (starting February 2020). For the last three years a total of 556 appointments was performed. The targeted patients had systemic inflammatory rheumatic diseases, mainly rheumatoid arthritis, psoriatic arthritis and spondylarthritis treated with sc classic and biological DMARDs. Appointments are scheduled at week 0 and 4 of starting these therapeutics and also whenever needed, at the request of the patient or the treating physician, in order to ensure a good nurse availability to clarify doubts at the beginning of these treatments. In the specific case of sc methotrexate, a protocol was created by the Rheumatology multidisciplinary team, defining the parameters eligible for evaluation, and the respective procedures of care. During appointments nurses also assess specific disease implications in the person's daily life, both physical, emotional and social domains. Additionally, this is an opportunity to reinforce reliable information on disease management, coping strategies, including information how to manage medication side effects. <h3>Conclusion</h3> The rheumatology nursing outpatient clinic provides key additional care and monitorization to patients with systemic inflammatory rheumatic diseases, treated with sc classic and biological DMARDs. Nurses improve the management of chronic diseases, namely by promoting autonomy of the patient in self-administration of sc therapies at home, counselling and informing about possible adverse effects and respective management strategies, constituting a valid contribution to disease control and patient engagement and education. <h3>References</h3> [1] Matcham, F., Norton, S., Scott, D. L., Steer, S., &amp; Hotopf, M. (2016). Symptoms of depression and anxiety predict treatment response and long-term physical health outcomes in rheumatoid arthritis: secondary analysis of a randomized controlled trial. <i>Rheumatology (Oxford, England</i>), <i>55</i>(2), 268–278. [2] Primdahl, J. &amp; Esbensen, B.A. (2020). Rheumatoid arthritis. In S. Ryan (Ed.), <i>Nursing older people with arthritis and other rheumatological conditions</i> (pp.17–30). Switzerland: Springer Nature. [3] Ryan, S. (2020). Pain management. In S. Ryan (Ed.), <i>Nursing older people with arthritis and other rheumatological conditions</i> (pp. 97-111). Switzerland: Springer Nature. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.